ATI RN CAPSTONE PHARMACOLOGY STUDY GUIDE-LATEST 100% CORRECT GUIDE

1. A nurse is preparing to administer ipratropium by metered dose inhaler. What adverse effects should the nurse instruct the client to monitor for? The adverse effects that the nurse should teach the client to watch for when taking ipratropium is dry mouth and hoarseness. The nurse should teach the client to sip fluids and suck on sugar-free hard candies to help with the dry mouth and hoarseness. 2. A client has a new prescription for salmeterol. The nurse is teaching the client about adverse effects of the medication. What instructions should the nurse include in this education? The nurse should teach the patient that the medication can cause tachycardia, angina, and tremors. The nurse should teach the client to observe for chest pain, palpitations, arm pain, and/or jaw pain and if they occur to notify the provider right away. The nurse should teach the client to check pulse and to report a pulse that increases greater than 20 to 30 beats/min. The client should be taught that tremors usually resolve with the continued use of the medication. The client should be advised to avoid all caffeine and that the medication dose might need to be reduced or tweaked depending on adverse effects. 3. A nurse is caring for a client prescribed the inhaled glucocorticoid beclomethasone (QVAR) for the treatment of asthma. What is a potential adverse effect of this medication and what are two (2) teaching points to discuss to address these adverse effects? The adverse effects that a patient could experience are difficulty speaking, candidiasis, and hoarseness. The patient should be educated to rinse their mouth or gargle with water after each use of the medication. The patent should also be educated to monitor for redness, sores, or white patches in their mouth and if any of these occur to report them to their provider right away. They will need to treat candidiasis with nystatin oral suspension. 4. A nurse is administering gemfibrozil to a client with elevated cholesterol. Identify two (2) adverse effects related to this medication. The adverse effects the that patient could experience while taking this medication are GI distress, gallstones, myopathy, and hepatotoxicity. 5. A nurse is providing instructions to a client who has a prescription for methotrexate. What should the nurse include in the client education? The nurse should teach female clients to use birth control during and for at least 6 months after completing the medication treatment. Teach the patient that they will need to protect their skin from the sunlight during treatment. The nurse should teach the patient to take the medication on an empty stomach and to take the medication with folic acid. 6. A nurse is preparing to educate a client who has a new prescription for levodopa/carbidopa. What should the nurse include in the client instructions? The nurse should teach the patient the adverse effects of the medication are nausea, vomiting, drowsiness, dyskinesias, orthostatic hypotension, cardiovascular effects from beta one stimulation, psychosis, discoloration of sweat or urine, and activation of malignant melanoma. The client should be told that the discoloration in their urine and sweat is normal and harmless. The patient should be taught to watch their blood pressure and vitals and if they see a trend in elevation, they need to contact their provider. The client should be told to change positions slowly at first after starting the medication. The patient should be educated to avoid meals high in protein and to avoid vitamin preparations and foods containing pyridoxines. 7. A nurse has provided education to a client who has a new prescription for exenatide. What statements by the client would indicate they understand the instructions? The nurse should teach the patient to administer the medication subcutaneously into their thigh, abdomen, or upper arm. The patient should be told they need to take the medication 60 minutes before their morning and evening meals and to never take it after eating a meal. Teach the patient that the injection pen needs to be kept in the refrigerator and discarded after 30 days. The patient should be told that the adverse effects of the medication are nausea, vomiting, diarrhea, and pancreatitis. The patient should call the provider if they have any of the adverse effects. 8. A client has been prescribed timolol eye drops. What are three (3) possible adverse effects of this medication and nursing interventions/client education related to these effects? The first adverse effect that the patient might have would be stinging discomfort in the eye right after putting the drops in. The nurse should teach the client that this effect is transient and will go away. Another adverse effect that can come from the medications is occasional conjunctivitis, blurred vision, photophobia, and dry eyes. The nurse should teach the patient that they should report to their provider if they have any of these adverse effects. The other adverse effect that could happen with this medication is systemic effects of beta blocker on the heart and lungs. The nurse should teach the patient that an overdose could cause the systemic effects and that is their heart rate drops to less than 58 beats/min they need to call their provider. 9. An oncology client is prescribed filgrastim. What are the indications for this therapy? This medication is used to stimulate the bone marrow to increase production of neutrophils. A patient would be put on this medication to decrease the risk of infection in patients who have neutropenia from cancer or other conditions. The medication is used to build up the number of hematopoietic stem cells before they are harvested for autologous transplants. 10. A nurse is placing an IV line on an older adult client. List three (3) considerations the nurse should take when placing an IV line in this client? When starting an IV on an older client you want to avoid using a tourniquet instead you want to use a blood pressure cuff to help visualize the veins to help prevent hematoma formation. The nurse wants to avoid using the back of the patient’s hand, slapping the extremity to visualize veins, and avoid rigorous friction while cleaning the site. Have the patient hold their hand below the level of their heart to help visualize the veins. ...........................................................................CONTINUED